Antiretroviral therapy during tuberculosis treatment and marked reduction in death rate of HIV-infected patients, Thailand.

Antiretroviral therapy during tuberculosis treatment and marked reduction in death rate of HIV-infected patients, Thailand.
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DOI:
10.3201/eid1307.061506
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发表时间:
2007-07
影响因子:
11.8
通讯作者:
Varma JK
Varma JK
中科院分区:
医学2区
文献类型:
--
作者:
Akksilp S;Karnkawinpong O;Wattanaamornkiat W;Viriyakitja D;Monkongdee P;Sitti W;Rienthong D;Siraprapasiri T;Wells CD;Tappero JW;Varma JK

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抗逆转录病毒疗法与艾滋病毒感染结核病患者结核病治疗期间死亡率的大幅降低有关。抗逆转录病毒疗法(ART)可以挽救晚期艾滋病毒感染患者的生命,但接受结核病(TB)治疗的艾滋病毒感染患者的获益程度仍不确定,而且发展中国家基于人口的数据有限。我们前瞻性地收集了2003年2月至2004年1月在泰国乌汶府感染艾滋病毒的结核病患者的数据。在12个月内,在登记接受结核病治疗的2,342名患者中,有329名(14%)被诊断出艾滋病毒。在已知结果的患者中,71名接受抗逆转录病毒治疗的患者中有5名(7%)在结核病治疗期间死亡,219名未接受抗逆转录病毒治疗的患者中有94名(43%)死亡。使用多变量分析,我们发现在调整CD 4计数、涂片状态、复方新诺明使用和治疗设施后,在结核病治疗前或治疗期间接受抗逆转录病毒治疗的患者死亡几率大幅降低(比值比,0.2; 95%置信区间,0.1-0.5)。在泰国,抗逆转录病毒疗法与艾滋病毒感染的结核病患者在结核病治疗期间死亡的大幅减少有关。
Antiretroviral therapy is associated with a substantial reduction in deaths during TB treatment for HIV-infected TB patients. Antiretroviral therapy (ART) is lifesaving in patients with advanced HIV infection, but the magnitude of benefit in HIV-infected patients receiving tuberculosis (TB) treatment remains uncertain, and population-based data from developing countries are limited. We prospectively collected data about HIV-infected TB patients from February 2003 through January 2004 in Ubon-ratchathani, Thailand. During 12 months, HIV was diagnosed in 329 (14%) of 2,342 patients registered for TB treatment. Of patients with known outcomes, death during TB treatment occurred in 5 (7%) of 71 who received ART and 94 (43%) of 219 who did not. Using multivariate analysis, we found a large reduction in the odds of death for patients receiving ART before or during TB treatment (odds ratio, 0.2; 95% confidence interval, 0.1–0.5), adjusting for CD4 count, smear status, co-trimoxazole use, and treatment facility. ART is associated with a substantial reduction in deaths during TB treatment for HIV-infected TB patients in Thailand.
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